Peripheral arterial disease includes a range of vascular syndromes caused by atherosclerosis and thromboembolic pathophysiological processes that alter the normal structure and function of the aorta, its visceral arterial branches and the arteries of the lower extremity.
Individuals at risk for lower extremity peripheral arterial disease should undergo review of vascular symptoms and comprehensive vascular examination to assess walking impairment, claudication, ischemic rest pain and/or the presence of nonhealing wounds.
Patients with peripheral arterial disease may be symptomatic or asymptomatic. Symptoms may range from claudication presenting as exertional leg pain to chronic limb-threatening ischemia presenting as rest pain, ulceration or gangrene.

Introduction

Peripheral arterial disease (PAD) includes a range of vascular syndromes caused by atherosclerosis and thrombolic pathophysiological processes that alter the normal structure and function of the aorta, its visceral arterial branches and the arteries of the lower extremity

Risk Factors

Individuals at Risk for Lower Extremity Peripheral Arterial Disease

Age <50 years old with diabetes mellitus (DM) and one of the following atherosclerotic risk factors:

Smoking

Dyslipidemia

Hypertension

Hyperhomocysteinemia

Age 50-64 years old with atherosclerotic risk factors or family history of PAD

May also occur as an acute event that causes symptomatic deterioration in a patient with known lower extremity PAD and intermittent claudication

Determine the cause of embolization and/or thrombosis in the patient’s history

Clinical diagnosis of arterial embolism:

Sudden onset or worsening of symptoms

Known embolic source (eg atrial fibrillation, severe dilated cardiomyopathy, left ventricular aneurysm, atheromatous plaque in the aorta or proximal limb arteries, or mural thrombus in the wall of an aortic or arterial aneurysm)

Absence of antecedent claudication or other manifestations of obstructive arterial disease

Earlier oral β blocker administration is substantially correlated with lower rates of left ventricular (LV) dysfunction and in-hospital mortality in acute coronary syndrome patients, according to a study.

The absence of the classical symptom of chest pain in patients with acute myocardial infarction (AMI) appears to be associated with more complications and higher short- and long-term mortality rates, particularly in younger and healthier patients, according to a study.